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Janice Eliis <br />From: support@civicplus.com <br />Sent: Wednesday, May 11, 2011 6:45 PM <br />To: Janice Ellis; Denene Taylor <br />Subject: Online Form Submittal: Application for Boards I Committee / Commission <br />If you are having problems viewing this HTML email, click to view a Text version. <br />Appiication for Boards / Committee / Commission <br />The Paris City Council is seeking committed individuals who are dedicated to Et►e well-being of the Paris community to serve on its <br />standing boards, commissions, and committees. In general, it is the City Council's potiey to appoint persons to a maximum of two <br />consecutive ful{ three-year terms on a given body. In addiUon to the generai qualificaGons {isied in the certificafiion below, other <br />qualifications may be martdated by statute, City Charter, ordinance, or resolutian. Please complete the information requested below. <br />First Name* Jerry Last Haning <br />Name' <br />Address" 1213 Pine Bluff <br />Paris State TX Zip' (X) 75460 75462 <br />City" ) 75461 <br />Telephone <br />(903) 123-4567* <br />Areas of InUerest* <br />Please note any specia( know{edge, education, or <br />experience you have that is applicable to the function <br />of the boarci, commission, or committee of interest <br />(attach additional pages if necessary). If applicable, <br />list dates of service on any City boards, commissions, <br />or committees. <br />Certification and Authorization <br />~ <br />903491-9349 903-784-4034 <br />Airport Advisory Boar'd Municipal Band Commission <br />Building & Standards. Commission f l Pa►'►s/Lamar County Board of <br />[ ] Civil Service Commission Health <br />Economic Development Ixl Planning & Zoning Commission <br />Corporation Pubiic Library Advisory Board <br />Historic Preservation Commission Traffic Commission <br />Housing Authority Board of [x] Z~~ing Board of Adjustment <br />Commissioners <br />[ ] Street Advisory Baard <br />Served on Fire and Building Code Review Committee in 2010. Was a <br />homehuilder in Paris and Lamar co. for 26 years. Changed to commercial <br />building and worked mostly out of town for 12 years. Now I am semi retired. <br />I acknowledge that 1 am aware and agree to the prohibitions of the City of Paris Charter and the laws of the State of Texas regarding <br />nepotism and conflicts of inter+est of appointees to City boarcls, commissions, and committees. I atso certify that if appointed I will <br />attend at teast 75 percent of all regular meetings and shall not have any delinquent indebtedness to the Ciry during my term. I <br />understand that the number of positions on a given board, commission, ar committee is limited and that I may not be appointed; <br />however, if I am not appointed, I agree to be placed in a database for possible future notification of topics of interest. I certity that the <br />information given by me in this application is true and corneCt and any false information or misrepresentation is sufficient grounds for <br />disqualification. I authorize the City of Paris to verify all information provided in this apptication. {n accordance with Section 552 of the <br />Local Govemment Code, I understand that information provided in this appiication may be avaitabte ta the public upon request.` <br />[XJ Agree <br />` indicates required fields. <br />[ ] Disagree <br />The following form was submitted via your website: Application for Boards / Committee / Corrunission <br />159 <br />